7 WLS Facts That May Surprise You

Article By: Rachel Ignomirello, MS, RDN, CSOWM, LDN

Rachel Ignomirello is a Bariatric Dietitian and Board-Certified Specialist in Obesity and Weight Management.

With bariatric program education and the world wide web, patients are very knowledgeable about surgery these days. Despite having all that knowledge, there are still many bariatric surgery facts that may surprise you!

1) Doing nothing about obesity is riskier than the actual surgery. Any surgery has risks, but bariatric surgery has been found to be one of the safest surgeries to undergo. Over the years, the procedures have improved and are a lot safer now. In fact, the American Society for Bariatric and Metabolic Surgery (ASMBS) reports that there is only a 4.3% chance of having a major complication. The risks of obesity (diabetes, heart disease, stroke, death) are far more dangerous.

2) Recovery is surprisingly fast. When coming home from surgery, patients do have to take it easy for a while. The body needs time to recover and heal during that initial period. However, recovery goes quickly these days because patients are more active – even on the day of the surgery! Walking short distances improves circulation for healing. For returning to work, most patients are back within 2-4 weeks depending on how active the job is.

3) Fat loss can be all over the body. Even though we often think about stored fat around the belly, fat mass is stored all over. As you lose weight with bariatric surgery, you are losing a lot of that fat mass. Because of this, some crazy things may happen. Some patients will notice that they shrink! It’s not because bones change. It’s because the fat pads on the soles of the feet become smaller. For this same reason, some patients notice a decrease in shoe size. Other accessories or medical devices may also start to fit differently. This can include glasses and dentures because fat pads in the cheeks decrease. The most common accessory change that patients notice are looser-fitting rings. Depending on how loose the rings feel, resizing can help. I always love hearing, “I was able to fit into my wedding ring again!”

4) Body image may change. Even though weight loss may be gradual enough for the body to adjust, many people are left with excess skin. Cosmetic surgery may help with that but is often not covered by insurance. I encourage patients to focus on positive changes as best they can: a healthier body, more energy, less shortness of breath, etc! It may take time, but it’s important to appreciate the body for what it can do.

5) Relationships may change. Any time we undergo change, it can be stressful. After bariatric surgery, there are a lot of changes and a lot of emotions. This impacts the patient and those around them. There have been studies that suggest divorce rates increase following bariatric surgery. I think it comes down to how the relationship was doing prior to surgery: strong relationships will survive, and weak relationships may break. Have open communication and try to include friends and family in the bariatric process. If needed, counseling can be beneficial.

6) You can regain weight after surgery. Bariatric surgery is not an easy fix for weight loss. Once the period of rapid weight loss slows, it comes down to patient responsibility and compliance. After all, the surgery does not shop, cook, eat, or exercise for the patient! It is a tool that can propel weight loss but requires hard work to keep the weight off. Regain is possible, especially if the patient is grazing, ignoring fullness signals, and/or is inactive.

7) Bowel movements may change. When having surgery on the gastrointestinal (GI) tract, expect some GI changes. Loose stools, constipation, and dumping syndrome are common complaints after bariatric surgery. Loose stools can be common when on a liquid diet but should improve once the diet becomes denser. Bowel movements do decrease due to the reduced food/fiber intake, but fluids will help keep things moving. A bowel movement every 2-3 days can be normal for many patients. Dumping syndrome occurs after poor food choices and is mostly in gastric bypass patients. Concentrated sweets or greasy/fried foods can cause the classic “dumping” symptoms like nausea, cramping, and diarrhea.

BariMelts provides general recommendations, not to be construed as medical advice. Please consult your doctor.